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At least in the initial period, there appears to be no clinically meaningful difference in IQ scores in pediatric patients after a concussion.
Source
IQ After Pediatric Concussion. Pediatrics. 2023. 152(2);e2022060515. https://doi.org/10.1542/peds.2022-060515.
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Post-concussion return to functional baseline occurs early for symptoms, balance, and mental status along with partial neurocognitive functioning. Visual-memory and reaction-time recovery, however, lag behind the other groups post-concussion.
Source
Time to Recovery as Measured on Clinical Assessments after Sport-Related Concussion. N Engl J Med. 2023 May 4;388(18):1717-1719. doi: 10.1056/NEJMc2301706.
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In a meta-analysis of 1,685 patients with suspected scaphoid fracture after negative plain radiographs, no clinical feature adequately rules out occult fracture.
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This meta-analysis found Boss-Holzach-Matter/Davos and FARES had the most favorable value for success rates, while both FARES and modified external rotation were more favorable in reduction times. FARES also had the most favorable score for pain during reduction.
Source
A Systematic Review With Pairwise and Network Meta-analysis of Closed Reduction Methods for Anterior Shoulder Dislocation. Annals of emergency medicine vol. 81,4 (2023): 453-465. doi:10.1016/j.annemergmed.2022.10.020
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This study supports the notion that an early return to school (RTS), results in faster recovery from concussion symptoms versus prolonged absences.
Source
Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Netw Open. 2023 Jan 3;6(1):e2251839. doi: 10.1001/jamanetworkopen.2022.51839.
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Intra-articular lidocaine (IAL) is a safe alternative for the reduction of anterior shoulder dislocations and may have similar efficacy to intravenous (IV) sedation, with fewer adverse events and shorter ED length of stay.
Source
Intra-articular lidocaine versus intravenous sedation for closed reduction of acute anterior shoulder dislocation in the emergency department: a systematic review and meta-analysis. CJEM. 2022 Dec;24(8):809-819. doi: 10.1007/s43678-022-00368-z. Epub 2022 Oct 1.
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Electrocautery trephination of acrylic nail products attached to simulated digits was associated with a high likelihood of ignition (83/200; 41.5%). Based on this limited data, electrocautery trephination of acrylic nails should be avoided to reduce risk of further patient harm.
Source
Up in Flames: The Safety of Electrocautery Trephination of Subungual Hematomas with Acrylic Nails. West J Emerg Med. 2022 Feb 23;23(2):183-185. doi: 10.5811/westjem.2021.10.53567.
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Skeletal muscle relaxants (SMRs) + nonsteroidal anti-inflammatory drug (NSAIDs) do not improve outcomes any more than placebo + NSAIDs in the treatment of low back pain (LBP). Even when stratified by age, sex, history of LBP, and initial severity, SMRs still did not win against placebo.
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In this large registry study, SARS-CoV-2 infection in young competitive athletes carries a low prevalence of cardiac involvement (0.5-3%) and low risk of clinical events in short-term follow-up.
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Patients who received opioids in the ED for low back pain were significantly more likely to return to the ED within 30 days for the same complaint when compared to those who received only NSAIDs, acetaminophen, or a combination of the two.
